Abstracts 365

for bum patients. Burns 19, (2), 131-133. Zaets T. L. and Tarasov A. V. (1992) The correction of metabolic

disorders in severely burned patients by enteral hyperalimen- tation. Nufr. Hosp. 7, (6). 411-417.

Zhang R. Q. and Luo C. J. (1992) Hematopoietic response to

thermal injury. Chting Hua Cheng Hsing Shao Shng Wui Ko Tsu Chih 8, (2), 141-143.

Zhou Y. P., Zhou Z. H. and Xue J. 2. (1993) Bums complicated with gastrointestinal haemorrhage - an analysis of 70 cases. Bum 19, (2), 150-152.

Abstracts

CLINICAL STUDIES

Epidermal growth factor receptor mediated tissue repair Studies in 32 patients with bums covering between 2 and 88 per cent TBSA examined the histochemical localization of epidermal growth factor receptor (EGFR) in bum wound margins, adjacent proliferating epithelium and closely associated sweat ducts, sebaceous glands and hair follicles.

Two to 4 days after burning prominent staining for EGFR was found in undifferentiated marginal keratinocytes, adjacent pro- liferating hypertrophic epithelium and both marginal and non- marginal hair follicles, sweat ducts and sebaceous glands.

Between 5 and 16 days after injury the EGFR was depleted along the leading epithelial margins but remained at high concentrations in the hypertrophic epithelium and all skin appen- dages.

Such findings indicate the role of EGF and its receptor during human wound repair.

Wenczak B. A., Lynch J. B. and Nanney L. B. (1992) Epidermal growth factor receptor distribution in bum wounds. Implications for growth factor-mediated repair. 1. Chz. Invest. 90, (6), 2392- 2401.

Long-term respiratory effects in burned and inhalation- injured children Cardiopulmonary performance levels were measured during the convalescence phase (2.6 * 1.9 yr after injury) of 40 children who had had severe burns, 16 of whom had also had a significant inhalation injury. Although both groups of children reached the same endurance level on the treadmill, the children who had suffered an inhalation injury did so with an increased expired volume, respiratory rate and ratio of dead space ventilation to total ventilation. Spirometry and lung volume studies at rest showed that 64 per cent of the inhalation-injured children had abnormal lung function compared with only 27 per cent of the children who only sustained bums.

Desai M. H., Mlcak R. I’., Robinson E. et al. (1993) Does inhalation injury limit exercise endurance in children convalescing from thermal injury. 1. Burn Care Rehabil. 14, (I), 12-16.

IL-6 levels, area of bum and the acute-phase reactant protein response Studies of interleukin-6 (IL-6) levels in plasma showed that compared with the levels in normal individuals surviving burned patients had levels that were about 10 times normal by 6 h after injury; in non-survivors they peaked at about 165 times normal at the same time. The peak levels correlated with total body surface area burned and tended to be higher in patients with concomitant inhalation injury. In surviving burned patients the peak IL-6 levels correlated with the levels of a variety of acute-phase reactant proteins. No such correlation was found in non-surviving burned

c 1993 Butterworth-Heinemann Ltd 0305-4179/93/040365-02

patients, where the acute-phase levels remained low. Ueyama M., Maruyama I., Osame M. et al. (1992) Marked

increases in plasma interleukin-6 in bum patients. 1, Lab. Clin. Med. 120, (S), 693-698.

Low-dose heparin and thromboembolic complications Thromboembolic complications appear to occur with a frequency of between 0.4 and 7.0 per cent in burned patients, some units therefore give routine low-dose heparin prophylaxis to burned patients. A review of 2103 patients treated at the Brooke Army bum treatment facility showed a 1.2 per cent incidence of pulmonary thrombo-embolism without low-dose heparin admin- istration.

A literature survey shows a 0.6-S per cent incidence of complications related to low-dose heparin therapy which includes bleeding, thrombocytopenia and arterial thrombosis.

The above findings question whether low-dose heparin should be given routinely. Its use should be confined to high risk patients.

Rue L. W., Cioffi W. G., Rush R. et al. (1992) Thromboembolic complications in thermally injured patients. World 1, Surg. 16, (6), 1151-1155.

Platelet counts, sepsis and survival Platelet counts were measured in 32 children who survived severe bums and in 32 chiidren with lethal bum injuries. All but one of the non-survivors developed a platelet count of less than 0.1 x 10” per litre. Only IO of the survivors had similar low platelet counts. A decline in platelet count preceded all other signs of sepsis. A platelet count below 0.1 x lOI2 per litre for more than 4 days was uniformly associated with death and hence had a high predictive value.

Housinger T. A., Brinkerhoff C. and Warden G. D. ( 1993) The relationship between platelet count, sepsis and survival in pediatric bum patients. Arch. Swg. 128, (1), 65-67.

Calorie needs of burned babies A comparison was made between the actual calorie intake needed to maintain the body weight of burned babies (up to 1 year old) with TBSA bums covering over 25 per cent and the calorie intakes suggested by published paediatric nutritional formulae. Multiva- riate regression analyses showed that body surface area and bum surface area were significant predictors of calorie needs, however body surface area was the dominant predictor.

The optimal equation was: 2100 Kcal per m2 body surface area per day plus 1000 Kcal per m2 bum surface area per day.

Hildreth M. A., Hemdon D.N., Desai M. H. et al. (1993) Caloric requirements of patients with bums under one year of age. 1. Burn Cure Rehbil. 14, (I), 108-112.